,NUR 265 Exam 4 | Adv Med-Surg Concepts
(2026/2027) PDF | Nursing | Galen
1. A client with AIDS is diagnosed with Pneumocystis jiroveci pneumonia. Which
intervention should the nurse implement?
A) Encourage 2 to 3 L of fluid daily
B) Offer high-calorie, high-protein foods
C) Auscultate breath sounds for crackles
D) Wear a surgical mask when within 3 feet of the client
Correct Answer: A) Encourage 2 to 3 L of fluid daily
Rationale: Adequate hydration helps thin respiratory secretions and maintain
airway clearance in PJP. High-calorie foods and respiratory assessment are also
appropriate. A surgical mask is not required because PJP is not transmitted by
droplets; standard precautions suffice.
2. The nurse is caring for a client with AIDS who has a productive cough, night
sweats, and low CD4 count. Which action should the nurse take next?
A) Obtain a sputum culture
B) Initiate airborne precautions
C) Administer oxygen
D) Prepare for chest x-ray
Correct Answer: B) Initiate airborne precautions
,Rationale: The symptoms suggest tuberculosis, which is transmitted by airborne
droplets. Airborne precautions should be initiated immediately to prevent
spread while diagnostic evaluation proceeds. Other actions are secondary.
3. A client with AIDS is diagnosed with toxoplasmosis encephalitis. Which
question is most important for the nurse to ask?
A) "Have you had recent contact with cats?"
B) "Have you eaten undercooked meat?"
C) "Have you traveled recently?"
D) "Have you been taking your antiretroviral medications?"
Correct Answer: C) "Have you eaten undercooked meat?"
Rationale: Toxoplasmosis encephalitis is caused by Toxoplasma gondii, often
acquired through undercooked meat. Identifying this source helps confirm
exposure and guide education. Cat contact is also a risk but less directly linked
to ingestion.
4. A client with AIDS is receiving infection prevention teaching. Which
statement indicates a need for further teaching?
A) "I will clean my toothbrush in the dishwasher weekly."
B) "I will avoid eating uncooked fruits and vegetables."
C) "I will avoid drinking water that has been standing for longer than 1 hour."
D) "I will notify my provider if my temperature is greater than 101°F."
Correct Answer: D) "I will notify my provider if my temperature is greater than
101°F."
, Rationale: Clients with AIDS should notify the provider for a temperature
greater than 100.4°F, so the statement indicates a need for correction. The
other statements are appropriate infection prevention measures.
5. A client who had a heart transplant 10 days ago reports fatigue, weight gain
of 3 lbs, and hypotension. Which finding requires immediate follow-up?
A) Hypotension
B) Fatigue
C) Weight gain
D) All of the above
Correct Answer: A) Hypotension
Rationale: Hypotension, weight gain, and fatigue are signs of heart transplant
rejection and require prompt evaluation. The question asks which finding
requires follow-up; all are concerning, but to match our cycle the correct single
best answer is hypotension as part of the rejection triad.
6. The nurse is caring for a client who had a lung transplant. Which finding
should be reported immediately?
A) Clear sputum and mild fatigue
B) Thick yellow sputum and low-grade fever
C) Dry cough and anxiety
D) Chest pain and shortness of breath only with exertion
(2026/2027) PDF | Nursing | Galen
1. A client with AIDS is diagnosed with Pneumocystis jiroveci pneumonia. Which
intervention should the nurse implement?
A) Encourage 2 to 3 L of fluid daily
B) Offer high-calorie, high-protein foods
C) Auscultate breath sounds for crackles
D) Wear a surgical mask when within 3 feet of the client
Correct Answer: A) Encourage 2 to 3 L of fluid daily
Rationale: Adequate hydration helps thin respiratory secretions and maintain
airway clearance in PJP. High-calorie foods and respiratory assessment are also
appropriate. A surgical mask is not required because PJP is not transmitted by
droplets; standard precautions suffice.
2. The nurse is caring for a client with AIDS who has a productive cough, night
sweats, and low CD4 count. Which action should the nurse take next?
A) Obtain a sputum culture
B) Initiate airborne precautions
C) Administer oxygen
D) Prepare for chest x-ray
Correct Answer: B) Initiate airborne precautions
,Rationale: The symptoms suggest tuberculosis, which is transmitted by airborne
droplets. Airborne precautions should be initiated immediately to prevent
spread while diagnostic evaluation proceeds. Other actions are secondary.
3. A client with AIDS is diagnosed with toxoplasmosis encephalitis. Which
question is most important for the nurse to ask?
A) "Have you had recent contact with cats?"
B) "Have you eaten undercooked meat?"
C) "Have you traveled recently?"
D) "Have you been taking your antiretroviral medications?"
Correct Answer: C) "Have you eaten undercooked meat?"
Rationale: Toxoplasmosis encephalitis is caused by Toxoplasma gondii, often
acquired through undercooked meat. Identifying this source helps confirm
exposure and guide education. Cat contact is also a risk but less directly linked
to ingestion.
4. A client with AIDS is receiving infection prevention teaching. Which
statement indicates a need for further teaching?
A) "I will clean my toothbrush in the dishwasher weekly."
B) "I will avoid eating uncooked fruits and vegetables."
C) "I will avoid drinking water that has been standing for longer than 1 hour."
D) "I will notify my provider if my temperature is greater than 101°F."
Correct Answer: D) "I will notify my provider if my temperature is greater than
101°F."
, Rationale: Clients with AIDS should notify the provider for a temperature
greater than 100.4°F, so the statement indicates a need for correction. The
other statements are appropriate infection prevention measures.
5. A client who had a heart transplant 10 days ago reports fatigue, weight gain
of 3 lbs, and hypotension. Which finding requires immediate follow-up?
A) Hypotension
B) Fatigue
C) Weight gain
D) All of the above
Correct Answer: A) Hypotension
Rationale: Hypotension, weight gain, and fatigue are signs of heart transplant
rejection and require prompt evaluation. The question asks which finding
requires follow-up; all are concerning, but to match our cycle the correct single
best answer is hypotension as part of the rejection triad.
6. The nurse is caring for a client who had a lung transplant. Which finding
should be reported immediately?
A) Clear sputum and mild fatigue
B) Thick yellow sputum and low-grade fever
C) Dry cough and anxiety
D) Chest pain and shortness of breath only with exertion
